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Name of Applicant: Tou...) of tr.Aao5oa- Date Received: to/21/ 2o2- Grant Amount: 1, i`l'j HB 05-1254: Evaluation Checklist for Entities For Covered Entity Applicant: Yes No Comments: Is the applicant a covered entity? Does the covered entity have a state approved water conservation plan in / Jury 2-001 accordance with statutory revision 37-60-126? (HB 04-1365)? �/ (If answered no to the above question)then, Does the covered entity have a locally adopted water conservation plan with defined water saving _goals? Did the applicant provide a written statement from the entity's governing PG , l board, stating the entity's commitment to the project and the entity's commitment to implementing long-term water saving measures and programs (w/authorized signature)? Did the applicant provide a cover letter with the entity's: name, contact information, and a signature of an individual with the authority to commit ✓ the resources of the entity? Did the applicant provide a list of people and/or organizations that will be e6. pc, _ involved in assisting with the grant project(list of who will be utilizing the grant money)? Characterizing Water System: Did the entity provide their annual retail water demand(Metered Water / 3 Use) for the past five years (in acre ft. or million gallons)? Did the entity identify their retail water delivery(Distributed Water) for each of the past five years (in acre feet or million gallons)? �� (Not required,but preferred),Did the applicant provide information « V �, characterizing past water use by sector, (e.g. residential, commercial, and wA i t P industrial) and the source (e.g. surface water, groundwater, etc). 4 Did the entity provide current(and if available past)per capita water use for the last five years and the basis for this calculation? Did the entity provide their past, current, and predicted future population \// PG 4 served by the entity, (and the source of this information)? �G d) Did the entity state the water savings that was accomplished in the past five years through water conservation efforts? ✓ / Did the entity state water savings goals to be achieved through the implementation of the"project"? Adequacy, Stability, and reliability of the entity's water system *to be measured and examined by staff through analysis Description of Project: 2r Did the applicant write a paragraph stating the purpose and the primary features of the project? Did the applicant provide a detailed narrative (description) of tasks to be performed with grant monies (stating how grant money will be used to achieve project goals)? *(a"scope of work"can combine this item with the timeline described below)